Reprogrammed Human Lateral Ganglionic Eminence Precursors Generate Striatal Neurons and Restore Motor Function in a Rat Model of Huntington's Disease.

Abstract

BackgroundHuntingtons disease (HD) is a genetic neurological disorder predominantly characterised by the progressive loss of GABAergic medium spiny neurons in the striatum resulting in motor dysfunction. One potential strategy for the treatment of HD is the development of cell replacement therapies to restore neuronal circuitry and function by the replacement of lost neurons. We propose the generation of lineage-specific human lateral ganglionic eminence precursors (hiLGEP) using direct reprogramming technology provides a novel and clinically viable cell source for cell replacement therapy for HD. MethodshiLGEPs were derived by direct reprogramming of adult human dermal fibroblasts (aHDFs) using chemically modified mRNA (cmRNA) and a defined reprogramming medium. hiLGEPs were differentiated in vitro using an optimised striatal differentiation medium. Acquisition of a striatal precursor and neural cell fate was assessed through gene expression and immunocytochemical analysis of key markers. hiLGEP-derived striatal neuron functionality in vitro was demonstrated by calcium imaging using Cal-520. To investigate the ability for hiLGEP to survive, differentiate and functionally integrate in vivo, we transplanted hiLGEPs into the striatum of quinolinic acid (QA)-lesioned rats and performed behavioural assessment using the cylinder test over the course of 14 weeks. Survival and differentiation of hiLGEPs was assessed at 8 and 14-weeks post-transplant by immunohistochemical analysis. ResultsWe demonstrate the capability to generate hiLGEPs from aHDFs using cmRNA encoding the pro-neural genes SOX2 and PAX6, combined with a reprogramming medium containing Go6983, Y-27632, N-2 and Activin A. hiLGEPs generated functional DARPP32+ neurons following 14 days of culture in BrainPhys media supplemented with dorsomorphin and Activin A. We investigated the ability for hiLGEPs to survive transplantation, differentiate to medium spiny-like striatal neurons and improve motor function in the QA lesion rat model of HD. Fourteen weeks after transplantation, we observed STEM121+ neurons co-expressing MAP2, DARPP32, GAD65/67, or GABA. Rats transplanted with hiLGEPs also demonstrated reduction in motor function impairment as determined by spontaneous exploratory forelimb use when compared to saline transplanted animals. ConclusionThis study provides proof-of-concept and demonstrates for the first time that aHDFs can be directly reprogrammed to hiLGEPs which survive transplantation, undergo neuronal differentiation to generate medium spiny-like striatal neurons, and reduce functional impairment in the QA lesion rat model of HD. Significance statementThe present study reports for the first time that human lateral ganglionic eminence precursor (hiLGEP) cells directly reprogrammed from adult human fibroblasts using chemically modified mRNA can survive transplantation into the quinolinic acid-lesioned rat striatum and generate medium spiny striatal neurons. Most importantly, the authors show that transplantation of directly reprogrammed hiLGEPs restores motor function impairment by 14 weeks post-transplantation. This work provides proof of concept and demonstrates that directly reprogrammed hiLGEPs offer an effective and clinically viable cell source for cell replacement therapy to treat Huntingtons disease.